Buying Snake Oil
Trigger warning: Discussion of the decision to get weight loss surgery.
On the eve of Weight Stigma Awareness Week, which begins today, the insidious nature of weight stigma hit home. It was a Thursday evening. I was attending a meeting for one of my volunteer groups that I’ve been in long enough I feel as though many of them are like family. When I got the news that I lost the genetic lottery, they were among the first people to find out and they’re a small number of the people I am honest with about how I’m feeling.
Having gone through an adrenal crash a few days prior, there were many inquiries about my health. Of course, I’m not the only one with issues. One of my mentees had been out for several months because his wife was sick. At the end of the night I’d asked him how she was doing. He told me that because she’d made a full recovery, he could focus on getting his “gastric surgery.” His words didn’t process immediately. I stared at him for a moment and then he added, “I’m tired of being the old, fat man.” Fat man… gastric surgery… the bulb in my brain suddenly lit up.
As a libertarian, I tend to adhere to the belief that people should be free to do what they want with their own bodies. By that logic, I should support weight loss surgery for those who want it. My source of conflict lies in the concept of informed consent. I don’t believe the doctors who push the surgery give enough information. They sell the procedure as the magic bullet for weight loss, while glossing over the complications.
It is a conflict because I also believe very strongly in personal responsibility. A doctor can tell a patient that weight loss surgery will make their poop smell like cotton candy and a patient can do their own research to determine it isn’t so. Seeing a doctor is a lot like seeing an auto mechanic — you can be taken advantage of if you don’t do your own research. Doveryai no proveryai, trust but verify. It might take the form of a second opinion, a literature search, the experiences of others, or something else. I can suggest he does his own research, but it’s ultimately up to him to decide how much, if any, to do.
Then the other shoe dropped. His real motivator for having the surgery is to inspire his wife to have it. We know the outcomes of weight loss surgery are wildly variable. What if his is the rare success and hers is the more typical fail? What if his succeeds at first, then fails soon after she goes through with it? The odds are that both of them will be failures, with a host of new problems. Maybe his will be a failure straight away and she’ll decide it’s not the best thing for her. Maybe his will be the rare success and she’ll still decide it’s not for her.
Personally, I am opposed to bariatric surgery, which my computers wants to auto-correct to barbaric surgery. At best, I think it’s surgically-induced aversion therapy. At worst, I think it’s a forced eating disorder. Everything I’ve read about it makes me scream HELL NO! That is the choice that is best for me. As much as I want to tell him not to do it, he has to decide what is best for him. He believes it will cure his diabetes and sciatica. Another guy in our group was experiencing a flare-up of sciatica that night. The other guy was thin, so he’s treated with painkillers. My mentee is not; he gets treated with instructions to lose weight. When “lose weight” is the impossible treatment for everything, I can understand trying anything to make weight loss happen.